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DATE MN/DD <br /> �= = a 512_012 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION. <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> SHINSTROM & NORMAN, INC. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> P.O. BOX 638 COMPANIES AFFORDING COVERAGE <br /> KIRKLAND, WA 98083 COMPANY <br /> 425 827-6200 FAX: 827-5040 A American Econom Ins.Co. A XV <br /> INSURED <br /> COMPANY <br /> FINANCIAL CONSULTING SOLUTIONS GROUP B American States Ins. Co. iA XV) <br /> 7525 166TH AVENUE NE, STE #D-215 COMPANY <br /> REDMOND, WA 98052 C <br /> COMPANY <br /> I Dy <br /> OME _ — ymay" n` ? z "- '7 .�" '' <br /> S <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> CO TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR DATE(MM/DDNY) DATE(MMOD/YY) <br /> GENERAL LIABILITY GENERAL AGGREGATE $2 1 1 1 1 1 1 <br /> X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $2 1 1 1 too <br /> A ,CLAIMS MADE X OCCUR PERSONAL&ADV INJURY $1 i I 1 1 1 <br /> A OWNER'S&CONTRACTOR'SPROT 02-CE-223291-1 09-20-11 09-20-12 EACH OCCURRENCE $1 000 000 <br /> FIRE DAMAGE(Any one fire) $1 000 000 <br /> MED EXP(Any one person) $ 10,000 <br /> AUTOMOBILE LIABILITY <br /> ANY AUTO COMBINED SINGLE LIMIT $ <br /> 1 tat 110 <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> A X HIRED AUTOS 02-CE-223291-1 09-20-11 09-20-12 BODILY INJURY <br /> x NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: :_„ <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> EXCESS LIABILITY EACH OCCURRENCE $], 1 t . 1 /0 <br /> B X UMBRELLA FORM 01SU425565-10 09-20-11 09-20-12 AGGREGATE $1 000 000 <br /> OTHER THAN UMBRELLA FORM $ <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br /> EMPLOYERS'UABIUTY $ TORY LIMITS I rat �3Ss <br /> EL EACH ACCIDENT $1 1 1 1 / , 1 <br /> THE A PARTNE S/EECU INCL 02-CE-223291-1 09-20-11 09-20-12 EL DISEASE-POLICY LIMIT $2 I t 1 I i t <br /> PARTNERS/EXECUTNE <br /> OFFICERS ARE: EXCL WASH. STOP GAP EL DISEASE-EA EMPLOYEE $1,000,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS <br /> City of Everett is named as an additional insured. <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> City of Everett EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> Public Works: Matt Welborn 45 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> 3200 Cedar Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> Everett, WA OFA Y KIND UPON THE CO •ANY, ITS AGENTS OR REPRESENTATIVES. <br /> 98201mwelborn@ci.everett.wa.us Au .t•7„O EPRESENTATNE <br /> A. <br /> A� K { 95)t � �` ts._ :� s � - ' , ke;101 -4:011VriMI 1s1F9rA <br />